The Honolulu Star-Advertiser acquired a database of Hawaii professional and vocational licenses from the state Department of Commerce and Consumer Affairs. The newspaper filtered the database to build a list of physicians and physician assistants licensed in the state.

There is no publicly available national list of physicians disciplined by state medical boards. Although the National Practitioner Data Bank, created by Congress, contains information on malpractice settlements and adverse actions, the reports that it contains are confidential. The data bank contains a public use file, but information identifying individuals has been removed and a user agreement prohibits people from using the data set to identify anyone.

So the newspaper obtained publicly available lists of physicians and physician assistants disciplined by licensing boards from each of the 49 other states.

Most states post licensing and discipline information on websites, although the availability and presentation of information is inconsistent across states. Hawaii, for example, removes discipline information from its website five years after the terms of discipline have been completed. Arizona posts only "recent" decisions — those issued in the last 24 months. Washington state has no separate area for discipline decisions on its website, but all legal documents issued after 1998 are available when searching doctors by name. The Star-Advertiser compared the available discipline lists against the list of physicians licensed in Hawaii.

Because many people have the same names, the Star-Advertiser used public documents, legal records, websites and databases to verify that the doctors who faced action elsewhere were the same ones licensed in Hawaii. The newspaper compiled a list of cases where Hawaii discipline either was slow to follow discipline in other states or not apparent to consumers. In addition, the newspaper checked discipline records in some high-profile local cases. The list can be viewed at data.staradvertiser.com/docs. The newspaper did not include minor infractions, such as failure to maintain necessary continuing medical education credits, or cases where Hawaii action was more than 10 years old.